Public Health

Just a week after a June 13 summit at which public and private donors committed $4.3 billion to continue funding the GAVI Alliance’s efforts to immunize the world’s poorest children, another vaccines summit played out in Seattle. The Pacific Health Summit, a yearly conference examining a different global health issue, convened June 21-23 with the goal of connecting decision makers in science, industry, policy, and public health to improve health by combining the latest in scientific advances with industrial innovation and effective policy. Past topics have included multi-drug resistant tuberculosis, maternal and child health, malnutrition, and pandemic influenza. More

Last December, the History of Vaccines blog covered the introduction of MenAfriVac to the African meningitis belt, an area stretching from Senegal to Ethiopia, where epidemic waves of meningitis occur and can last up to three years. In the largest of these epidemic waves in history, meningitis killed more than 25,000 people from 1996 to 1997.

Polysaccharide vaccines are sometimes used to try to control outbreaks after they have begun: so-called “emergency vaccination” efforts designed to keep meningococcal epidemics from spreading further. However, these types of reactive efforts are very expensive and difficult to manage, and polysaccharide vaccines do not induce long-lasting immunity against meningococcal bacteria. (For more about the different types of vaccines, see our article and Types of Vaccines activity.)

Within these African epidemics, between 80 and 85% of cases are caused by a single group of meningococcal bacteria: group A. In 2000, a group of global health leaders gathered together by the World Health Organization (WHO) determined that a meningitis vaccine could be developed specifically for use in Africa: a low-cost vaccine that would focus solely on the Group A bacteria. The Bill & Melinda Gates Foundation provided a ten-year grant for what would become the Meningitis Vaccine Project (MVP). More

The latest episode of "No Bones About It," The College of Physicians of Philadelphia's popular YouTube series, features historian Michael Willrich. Willrich recently spoke at the College for a well-attended History of Vaccines event and discussed his most recent book, POX: An American History, which chronicles the smallpox outbreaks at the turn of the 20th century. Before the event, he sat down with Robert Hicks, director of the Mütter Museum and the College's Historical Medical Library, and the host of "No Bones About It." In this episode, Hicks and Willrich discuss compulsory vaccination, the intersection between civil liberties and public health, and the beginnings of the American anti-vaccination movements in the late 19th century. More

National Infant Immunization Week is April 23-30 this year. This week, the History of Vaccines blog features posts about several diseases that can be prevented by vaccination of infants.

Rubeola, or measles (as it's more commonly known) is an extremely contagious viral disease. It causes a distinctive rash, fever that can reach 104°F or higher, runny nose, and cough, and has many potential complications including ear infection (in about 10% of cases) and pneumonia (about 5% of cases). In about one in a thousand cases, the patient develops encephalitis, a swelling of the brain. About one out of every thousand patients will die.

The rubeola virus spreads easily and rapidly via coughs and sneezes, and remains active and infectious in the air for up to two hours. As a result, a person can become infected just by breathing the air in a room that was occupied by a measles patient as much as two hours earlier. There is no treatment for the disease, although supportive care may be provided, and efforts may be made to lower the patient's fever. More

National Infant Immunization Week is April 23-30 this year. This week, the History of Vaccines blog features posts about several diseases that can be prevented by vaccination of infants.

Although its name is not as well known as those of diseases like chickenpox or measles, rotavirus is the most common cause of severe diarrhea in children and infants worldwide. Before a vaccine was introduced in the United States, the disease caused more than 400,000 doctor's visits and 200,000 emergency room visits each year, causing as many as 60 deaths annually in U.S. children younger than five.

The virus spreads easily among children, and can also be passed from children to those with whom they're in close contact. Rotavirus spreads via the fecal-oral route -- that is, from the waste of an infected person to the mouth of another individual. This can occur via contamination on hands or objects like toys.

Rotavirus can be prevented by vaccination. The first dose of the vaccine series is recommended at two months of age. More

National Infant Immunization Week is April 23-30 this year. This week, the History of Vaccines blog will feature posts about several diseases that can be prevented by vaccination of infants.

Diphtheria, now nearly unknown in the United States, was once a common childhood affliction. In 1921 the country recorded more than 200,000 cases and more than 15,000 deaths, with the highest percentage of fatal cases among children younger than five. Although the last recorded case in the United States was in 2003, diphtheria remains endemic in many countries.

The disease is caused by a bacterium, Corynebacterium diphtheria, although the actual damage is not done by the bacterium itself. Instead, it secretes a toxin that damages the body's tissues. The most unique symptom of diphtheria is a thick gray substance that can spread over the nasal tissues, tonsils, larynx, and/or pharynx. This substance, called a pseudomembrane, can block the airways; in fact, diphtheria was known in Spain as "el garatillo" -- "the strangler." The toxin produced by the bacterium can also travel through the bloodsteam and damage other organs. More

In October 2010, cholera broke out in Haiti for the first time in decades, devastating the country while it was still recovering from the 7.0 magnitude earthquake that killed hundreds of thousands and left millions homeless just nine months earlier. In typical conditions, cholera can be treated easily with an oral rehydration solution or, in severe cases, via intravenous fluids to replace what is lost to vomiting and diarrhea. With quick treatment, nearly all patients recover. Left untreated, however, the dehydration and shock caused by the disease can kill within a matter of hours.

In Haiti, the country’s already-poor infrastructure had been additionally damaged by the earthquake, leaving conditions ripe for water- and food-borne diseases; within a month’s time, the cholera outbreak had spread across the country and killed almost 1,000 people. By the end of the year the death toll in Haiti had passed 3,000, and the Haitian government predicted that there would be more than 400,000 cases by the end of October 2011. Now, researchers at the Harvard School of Public Health and the University of California San Francisco have found that the number may reach almost twice that, predicting 779,000 cases of cholera and 11,100 deaths by the end of November. More

On March 1, The History of Vaccines hosted "Vaccine Science, Realities, and Fears in the Popular Mind" at The College of Physicians of Philadelphia. Paul Offit, MD, an infectious disease physician and vaccine developer, and Seth Mnookin, a contributing editor at Vanity Fair, discussed their new books as well as the past and future of vaccination as depicted in the media, among parents, and in the medical world. More

Despite global efforts to disrupt malaria transmission using mosquito nets and drug therapies, the disease remains widespread: hundreds of millions of cases occur each year, causing hundreds of thousands of deaths. While these measures can help to control the disease, an effective vaccine against malaria would be a major contribution to global public health.

The leading candidate vaccine against malaria is the RTS,S vaccine, which is currently in Phase III trials in seven countries in Africa. (Phase III trials are used to confirm the effectiveness of a drug as determined in Phase II trials, as well as to continue monitoring the drug for safety.) While this vaccine offers only partial protection against malaria—prior data showed it to be 53% effective eight months after vaccination—even this level of protection would be a significant improvement to public health efforts. More

Because influenza viruses frequently mutate, a new seasonal flu vaccine is developed each year in order to keep up with the circulating strains. Each year, the vaccine provides protection against three strains: two influenza A strains and one influenza B. The flu vaccine for the 2010-2011 flu season provides protection against a 2009 H1N1 A strain, H3N2 A strain, and an influenza B strain More